Stop trashing GPs – as another fall in the number of doctors is announced, we need to stop the rot

Instead of constantly carping about GPs' working practices, we should try being a bit nicer to them. People might be surprised at how effective a little public esteem can be

James Moore
Thursday 30 March 2017 12:52
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150 GPs left the profession each month between September and December 2016
150 GPs left the profession each month between September and December 2016

Despite a gaudy Government promise to hire 5,000 new full time equivalent GPs by 2020, the latest figures from the NHS have revealed yet another fall in their numbers.

Some 445 family doctors quit the profession between September and December 2016; a rate of nearly 150 a month.

It has become fashionable in certain circles (no prizes for guessing which) to blame immigration for the long waits people in certain “un-doctored” parts of the country face for appointments.

As these figures demonstrate, the truth is rather different. The problem is caused not by too many people, but by too few doctors.

Theresa May challenged whether £350m NHS funding promise from Leave campaigners will exist

People coming to Britain to work here tend, anyway, to be younger, and healthier than the population at large, which is ageing. Older people call on their GPs' services much more than do younger ones. It is an inevitable consequence of the ageing process.

The net result is that the current shortage of supply comes at a time of rising demand. You don’t need a degree in economics to see what happens when you mix those two together.

“A huge blow,” is how the Royal College of GPs described the figures, while at the same time insisting that the 5,000 target is “worth fighting for”. No one would dispute that.

But what to do about it? A start might be immediately guaranteeing the rights of EU citizens who live here. I hate to have to bring it back to Brexit, but we are not creating enough GPs of our own, and even were we doing so, they take as long as 10 years to train.

Making medics from the EU feel unwelcome isn’t a terribly clever thing to do in the midst of a crisis of supply. It’s highly unlikely that Dr Nowicki or Dr Fernandez are going to have the Home Office knocking at the doors of their surgeries in two years, or even in ten years, which might be a better estimate for when Britain's ludicrous plan to leave the EU might be complete.

But ask how you’d feel as a GP working in Poland or Spain if you were to hear a minister like Home Secretary Amber Rudd floating a measure that might require your practice to put your name on a register of foreign workers.

Talking of overseas doctors, here's one thing that shocked me. While in conversation with the Royal College of GPs as I researched this article, I was told that despite the recruitment crisis faced by the service, they are not on the list of shortage occupations maintained by the Migration Advisory Committee. Were they to be so, as nurses are, it would ease the path to these shores of non EU doctors. Perhaps health secretary Jeremy Hunt might like to arrange a meeting with Amber Rudd?

Taking steps to encourage more doctors from overseas will not solve the problem by itself, however, and there is also a certain question of morality. Doctors, generally, are a scarce resource. Trying to solve our shortage exclusively by poaching other people’s and creating one for them is the wrong way to go.

What we need to do is train more of our own doctors, as the RCGP recognises, and then make becoming a GP a more attractive option to them.

While efforts are being made to do that, they are not helped by some of the media coverage around the issue.

I’m not a great fan of continually harping on about how wrong the Daily Mail is, but when Britain’s best-selling newspaper launches a broadside against part time GPs leaving patients “betrayed" what can you do?

A leader for the paper in January fulminated about a service with “working practices tailored to suit staff, not patients” while bemoaning surgeries that allegedly close on a Wednesday afternoon.

Professor J Meiron Thomas, a surgeon, has also criticised the reliance by the NHS on female doctors who – shock horror – sometimes get pregnant and take time off as a result.

Here's the thing: which would you prefer? A part-time female GP or no GP?

Far from discouraging part-time GPs, we should be encouraging them. If we were able to persuade more women doctors to remain in general practice by working part time we’d be a long way towards solving the problem. One thing that might be getting in the way of that at the moment is that the hours imposed on part-time GPs equate to full time for most other people. That is the case with my (absolutely brilliant) female GP. Goodness knows what this says about the hours full time GPs end up putting in.

Instead of constantly carping about GPs' working practices, we should try being a bit nicer to them too. We ought to try being a bit nicer to public servants generally, instead of moaning about their contracts, and going on radio talk shows (as people often do) to say they shouldn’t complain about long hours when other people work long hours. People might be surprised at how effective a little public esteem can be. Respect is a rock hard currency.

GPs tend to be bright, highly skilled individuals, the sort of people who often have other options. If we don’t value them, it isn’t hard for them to find people that will.

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